ENT Business Meeting

Date: 01 November 2024 Time: 10:00 AM Location: ENT Department Meeting Room 2 Attendees: - Dr. Eleanor Vance (Consultant ENT Surgeon) - Nurse Manager Sarah Jenkins (Accident and Emergency Nurse) - Dr. Michael O'Connell (Junior Registrar) - Ms. Emily Carter (Department Administrator) Apologies: - Dr. Thomas Kelly (Consultant Anaesthetist, on leave) Agenda Items: - Review of Q3 Performance Metrics - Update on Staffing Ratios for Winter Period - Discussion on New Equipment Procurement for A&E ENT cases - Feedback on Recent Patient Safety Audit Action Log: - Update on procurement of new flexible endoscopes: Orders placed, delivery expected by end of November. Dr. O'Connell to track progress. Discussion Points around SAFE: - Risk Register - Detailed discussion on increased risk of delayed diagnosis for acute otitis externa during peak A&E hours due to staffing pressures. Proposal to review on-call rota. Reviewed new policy for managing foreign body removal in pediatric patients in A&E, noting clear pathways and reduced incident rates. - Incidents - Review of two recent minor incidents involving near-misses with shared equipment between ENT and A&E. Emphasised need for clearer decontamination protocols and communication. No major incidents reported. - SI Management - Discussion on the management of a recent unexpected death related to an undiagnosed laryngeal foreign body presenting in A&E. Comprehensive root cause analysis underway; initial findings shared regarding communication breakdowns. - External Visits - Preparation for CQC inspection next month. Focus areas identified: infection control in A&E ENT bays and documentation standards. - VTE Compliance - VTE prophylaxis compliance rates in A&E ENT admissions reviewed, showing 98% adherence for eligible patients. Commended nursing staff for consistent application. - Harm Reviews - Review of two cases of post-operative infection following tonsillectomy for A&E admissions. Discussion on re-evaluating antibiotic prophylaxis guidelines for emergency cases. Discussion Points around CARING: - Clinical Outcomes - Analysis of reduced waiting times for urgent ENT referrals from A&E. Positive feedback received from patients regarding communication during their A&E visits. Discussed the impact of the new triage system on patient satisfaction for acute ENT presentations in A&E. - Clinical Audits - Presentation of audit findings on acute epistaxis management in A&E. Recommendations include standardised packing materials and updated training for junior staff. Discussion Points around M&M: - Feedback on M&M - Positive feedback on the interdepartmental M&M meeting last month, specifically regarding the constructive analysis of the paediatric airway emergency case. Suggestions for similar joint A&E-ENT case reviews. Discussion Points around WELL-LED: - Feedback on staffing - Discussion on ongoing challenges with nursing staff shortages in A&E impacting ENT patient flow. Agreed to escalate recruitment needs to hospital management. Positive feedback on the new rotational programme for junior doctors between A&E and ENT. - Feedback on shared learning & good practice - Shared best practices observed in patient handovers between A&E and ENT teams. Discussed success of new educational workshops for A&E nurses on acute ENT conditions. Discussion Points around PERFORMANCE MONITORING: - Summary on performance monitoring - Overall positive trend in key performance indicators for ENT services within A&E, including reduced length of stay and improved patient flow. Areas for improvement include timely follow-up appointments post-A&E discharge. Decisions Made: - Approved procurement of new portable suction units for A&E ENT rooms. - Agreed to implement a bi-weekly joint A&E-ENT huddle to improve communication and patient handovers. - Decided to conduct a focused audit on documentation quality for ENT cases originating in A&E. - Summary of issues for escalation - Escalation of critical nursing staff shortages in A&E and their direct impact on ENT patient care to the hospital board. Escalation of the need for dedicated A&E-ENT training for new nursing staff. Action Items: - Dr. Vance: Draft proposal for joint A&E-ENT huddle structure. (Due: 15 November 2024) - Nurse Manager Jenkins: Prepare a detailed report on A&E nursing staff vacancies and their impact for escalation. (Due: 10 November 2024) - Ms. Carter: Circulate updated decontamination protocols for ENT equipment used in A&E. (Due: 05 November 2024) - Dr. O'Connell: Organise training sessions for A&E staff on acute epistaxis management. (Due: 30 November 2024) Next Meeting: - Date: 01 December 2024 - Time: 10:00 AM - Location: ENT Department Meeting Room 2